130 5th St - ReRoof ,� \ "A CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
�J131�
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- ROOF -270
Job Type: ROOF PERMIT
Description: reroof
Estimated Value: $9,446.00
Issue Date: 2/4/2016
Expiration Date: 8/2/2016
PROPERTY ADDRESS:
Address: 130 5TH ST
RE Number: 170168 -0000
PROPERTY OWNER:
Name: MCGEE, MARY S
Address: PO BOX 506240CK
GENERAL CONTRACTOR INFORMATION:
Name: BIG FISH ROOFING INC
Address: 6821 N SOUTHPOINT DR APT 114 STEVEN SCOATES
Phone: - -
FEES:
BUILDING PERMIT FEE $97.23
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $101.23
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT (904)853 -5676
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of r L County of DUVAL
To whom It may concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in
accordance with Section 713 of the Florida Statutes, the following information is stated in this NOTICE OF
COMMENCEMENT. C !f
Legal description of property being improved: /4 - 2S' - -2 ` 6 (`� 4 t 64.4.0.4
tv //$ E /1/ z-s 6/4-5; iv / /SFr ter I /Ij /' LZ
d (3 K //77 -347 / / N / !
Address of property being improved: 3/) .7 T if f 6 c. 4 J r-..�, 522 3 3
General description of improvements: REROOF
Owner / 19ri /4 ' /b lC 614
Address ur
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor
BIG FISH ROOFING
/ 71.1 : 1 - 1e)/1/
Address 6821 SOUTHPOINT DR N, SUITE 114, JACKSONVILLE, FL 32216
Phone No. Fax No.
(soa)sas - s33a
Surety (if any)
Address Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No.
Fax No.
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY ��C n,(/ OWNER
Signed: traC -, "� DATE �G -
1
Before me this day of in the
Doc # 2016024322, OR BK 17.416 Page 154, County of Duval, ate of F,1ori�l . has perso appeared
Number Pages: 1 n 1C +/ /e P . herein by
R ecorded 02'02'2016 at 02:05 PM, hi sen/ he 't 1 it +L C7 and affirms that all statements and declarations herein
are true and accurate
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY o n 11 S y K�.yt f vac T�' Co s on # F SIMMONS
�,Z C : l � , *: ��� : � Commission # FF 098012
RECORDING $10.00 Expires March 3, 2018
t 'S'` Bonded Thru Tray Fain Insurance 900.395 -7019
Notary Public at Large, State of Cou
My commission expires: 3 -3-
Personally Known or
Pmdrrrori IAnnt firwrinn !' , h i
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
/ Si.. Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: / 30 5/h J Permit Number:
Legal Description it )9 E G/ /15 &r N 2srr� f S k i s r-1 f u c
ViiAP Floor Area of i Sq.Ft. Paarrcel l # S Ft
Valuation of Work $ Proposed Work heated /cooled 26 '' n heated /cooled 2 Y
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial ! - '
Han existing structure, is a fire sprinkler system installed? (Circle one): Yes ` . N /A
Florida Product Approval # J k (@7t1 j
For multiple products use product approva of f iii
Describe in detail the type of work to be performed: Grim- and repo roof-
ref t40-- 1
Property Owner Information: fl
ox r y c 6 a Address: H ioX 500 L D Cl<
City ! State Zip Phone g 25/G - 2,09Z.
E -Mail or Fax # (Optional)
Contractor Information: nn CONTRACTOR EMAIL ADDRESS:
Company a e: I IC�rI J �
Qualifying Agent: ✓er 5e
60 Q1-
Address: (, od ,
d dr iu. Cit ( fizckfet✓i`Ca . State Ft Zip 3 2-24
Office Phone - 5 33y Job Site/ Contact Number Fax #
State Certification/Registration # ,Job 3 3 c '/
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give aut • ity to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
v"L /
Signature of Owner J�-- Signature of Contractor
ht A Print Name ''" - k- c � ee__ Print Name OtA/Rls. A, f coq er
Before me Before me
this Day of ftbu t rt , 20 1U this , Day of �, a , 20 go
ex ca
Notary Publ4 Comm # FF 098012 Notary Publi ; .- i �
.v 33 I! F
. Expires March 3, 2018
' F
,.� * 8... t • Bramcid Ma, i■oy Fain Insurance 900385 -7019 - 484, 0 f.41 1 144 , 2018